Provider Demographics
NPI:1417090721
Name:COUNTY OF STANLY
Entity Type:Organization
Organization Name:COUNTY OF STANLY
Other - Org Name:STANLY COUNTY DSS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOLLY
Authorized Official - Middle Name:H
Authorized Official - Last Name:CLAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-982-6100
Mailing Address - Street 1:1000 N 1ST ST STE 2
Mailing Address - Street 2:
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28001-2849
Mailing Address - Country:US
Mailing Address - Phone:704-982-6100
Mailing Address - Fax:704-983-5818
Practice Address - Street 1:1000 N 1ST ST STE 2
Practice Address - Street 2:
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-2849
Practice Address - Country:US
Practice Address - Phone:704-982-6100
Practice Address - Fax:704-983-5818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408438Medicaid